Background: Endosonography has been reported as the method of choice for local staging of patients with gastric lymphoma of mucosa-associated lymphoid tissue (MALT)-type. As endosonography is still restricted to specialized centers, we have investigated the use of spiral computed tomography of the abdomen with water-filling of the stomach (hydro-spiral CT) for enhanced contrast in patients with gastric lymphoma. Patients and Methods: Patients with a histological verified diagnosis of gastric lymphoma of MALT-type were included in this prospective series. All patients underwent routine staging procedures including endosonography of the upper GI-tract carried out by a single individual. In addition, patients were subjected to hydro-spiral CT either before or after endosonography within a maximal time span of 4 weeks. Results of hydro-spiral CT were compared to those of the endosonographic evaluation and histological work-up of biopsy specimens. Results: A total of 14 patients with primary gastric lymphoma of MALT-type (3 with a high-grade component) were studied prospectively. All patients underwent hydro-spiral CT before initiation of treatment, and 2 patients were also studied following chemotherapy. In the pretherapeutic setting, hydro-spiral CT identified gastric lymphoma in 8 patients, while a false negative result was seen in 6 patients. In addition, the localization of the lymphoma within the stomach was divergent between CT and endosonography in 1 patient. In the 2 patients who were also studied after therapy, CT showed unchanged thickening of the stomach wall in spite of normalization in the endosonographic assessment as well as the histologic evaluation. Conclusion: Our results demonstrate the superiority of endosonography over hydro-spiral CT for the staging and follow-up of patients with gastric lymphoma, who should therefore be managed at centers where endosonography is available.

1.
Zucca E, Roggero E, Bertoni F, Cavalli F: Primary extranodal non-Hodgkin’s lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997;8:727–737.
[PubMed]
2.
Isaacson PG, Wright DH: Malignant lymphoma of mucosa associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983;52:1410–1416.
[PubMed]
3.
Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR et al: Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 1991;338:1175–1176.
[PubMed]
4.
Isaacson PG: Gastric MALT-lymphoma: From concept to cure. Ann Oncol 1999;10:637–645.
[PubMed]
5.
Sackmann M, Morgner A, Rudolph B, et al: Regression of gastric MALT-lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging. MALT Lymphoma Study Group. Gastroenterology 1997;113:1087–1090.
[PubMed]
6.
Fischbach W, Dragosics B, Kolve-Goebeler M, et al: Primary gastric B-cell lymphoma: Results of a prospective multicenter study. Gastroenterology 2000;119:1191–1202.
[PubMed]
7.
Gossios K, Katsimbri P, Tsanios E: CT features of gastric lymphoma. Eur Radiol 2000;10:425–530.
[PubMed]
8.
de Jong D, Aleman BM, Taal BG, Boot H: Controversies and consensus in the diagnosis, work-up and treatment of gastric lymphoma: An international survey. Ann Oncol 1999;10:275–280.
[PubMed]
9.
Lee DH: Three-dimensional imaging of the stomach by spiral CT. J Comput Assist Tomogr 1998;22:52–58.
[PubMed]
10.
Harris NL, Jaffe ES, Stein EH, et al: A Revised European-American Classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group. Blood 1994;84:1361–1392.
[PubMed]
11.
Ruskone-Fourmestraux A, Lavergne A, Aegerter PH, et al: Predictive factors for regression of gastric MALT lymphoma after anti-Helicobacter pylori treatment. Gut 2001;48:290–292.
[PubMed]
You do not currently have access to this content.